Periods can be painful. They can be inconvenient. They can be exhausting. They can be distracting.
Women suffering from irregular or uncomfortable periods have long been prescribed the birth control pill to regulate their monthly cycle. Now, an increasing number of them are avoiding their periods altogether – by skipping the so-called sugar pills at the end of their monthly cycle and continuing directly to their next dose of daily hormones.
Is this safe? Are there any downsides?
Before I get into skipping periods, let’s not skip over how the pill works to avoid pregnancy. Estrogens and progesterones are hormones produced by the body that are necessary for sexual development and for the regulation of the menstrual cycle. Birth control pills contain synthetic estrogen and progestin analogues (combination pills) or just a progestin. These hormones prevent the ovaries from releasing an egg and if no egg is released then pregnancy cannot occur. Contraceptive pills also thicken cervical mucus, making it difficult for sperm to swim.
Menstruating women typically get their monthly periods when these hormone levels are low. The body discards the uterine lining (endometrium) that has been thickening all month in preparation for a fertilized egg. No fertilization means no need for the nutrients and nurturing from a thick endometrium.
To mimic that hormonal rhythm, pills containing an estrogen and a progestin are taken for 21 days followed by 7 days of pills that contain no hormones. The latter, containing only sugar, are simply a placeholder, so users don’t forget when to start the next pack. The cessation of pills with the active ingredients lowers hormone levels in the body and triggers menstruation usually after the first or second sugar pill.
However, if those inactive sugar pills are not taken, and instead the next pack is started immediately, hormone levels don’t drop and the uterine lining is not shed. No period!
So, why doesn’t everyone do this? No period, no brainer, right?
On a regimen of birth control pills the uterine lining doesn’t thicken as much, so shedding it is not as important. But breakthrough bleeding is a side effect that can occur between periods. This can manifest as spotting or a heavier flow, though breakthrough bleeding tends to decrease over time as your body adapts. Beyond this, there are generally no health risks.
Despite being considered safe, there is some controversy given that dysregulation of normal periods can be an indicator of some medical conditions such as endometriosis and ovarian failure. Skeptics have also argued that period-skippers are exposed to more hormones month to month than normal with possible detrimental effects. There has not been any research to support this yet. Another perspective is that some women rely on the onset of monthly bleeding as an indication that they aren’t pregnant.
If you are on the pill and want to try skipping periods, you should of course consult your doctor first. Each prescription is different. There are also other forms of contraception, such as IUDs, that will reduce the frequency of your period or even get rid of it altogether.
All that said, you might want to take a pregnancy test every month in place of buying tampons.
Note: “Women” was used throughout this article to describe menstruators, but we recognize that menstruating is not limited to women.
Haleh Cohn is studying Anatomy and Cell Biology at McGill University.
